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To analyze the incidence of renal trauma using the National Health Insurance Service Database (NHISD).Using the NHISD, representative of all upper urinary tract injuries in Korea, data regarding renal trauma were analyzed. The International Classification of Diseases, Tenth Revision Clinical Modification codes were used to identify the diagnoses. The incidence estimates of renal traumas were analyzed using Poisson regression analysis. Risk factors for high-grade renal trauma were estimated using multivariable logistic regression analyses.Patients with renal trauma were identified from a nationwide database collected by the National Health Insurance Service of Korea between 2012 and 2016. Among 37,683 individuals with renal trauma, 1,293 (3.4%) were diagnosed with high-grade renal trauma. Surgical therapy was performed in 995 (2.6%) patients with renal trauma and 184 (14.2%) patients with high-grade renal trauma. Renal trauma occurred in all age groups, and the ratio between men and women was approximately 3:1. Men and women experienced 8,000 (31.82/100,000) and 2,365 (9.52/100,000) renal trauma in 2013 (total 10,365, 20.73/100,000) and 5,243 (20.56/100.000) and 2,168 (8.58/100,000) in 2016 (total 7,411, 14.60/100,000), respectively. In multivariable analysis, female sex, age (age; 41-60 and 61-80 years), and comorbidity of peripheral vascular disease, renal disease, and malignancy were revealed as risk factors for high-grade renal trauma.Annual incidence of renal trauma is 17.33 per 100,000 population from 2012 to 2016. The incidence of kidney damage decreased gradually from 2013 to 2016, and the majority of renal trauma cases were low-grade. Conservative management was the preferred treatment modality in most patients with renal trauma, including those with high-grade renal trauma.

Herein, we review the assessment of quality-of-life (QoL) in radical cystectomy (RC) patients, summarize the result of studies for different surgical approaches, and provide an overview of patient management, as well as other considerations. In this review article, we reviewed the QoL research and research tools for patients undergoing RC, including urinary diversion methods, gender differences, and surgical methods (open surgery vs. robotic surgery). This narrative review focused primarily on articles indexed in PubMed, Embase, Scopus, and Google Scholar databases. We did not used formal search strategy and meta-analysis was not performed.

Bladder cancers have high recurrence rates and are usually removed via transurethral resection of bladder tumor (TURBT). Recently, some reports showed that the anesthetic method may affect the recurrence rates of bladder cancers. The purpose of this population-based study was to compare the effect of anesthetic methods with the recurrence rates of bladder cancers in South Korea. A total of 4439 patients were reviewed retrospectively using the data of the Korean National Health Insurance (NHI) claims database from January 2007 to December 2011. Patients were divided into 2 groups who received general (n = 3767) and regional anesthesia (n = 582), and were followed up until September 2017. Propensity score matching was conducted to reduce the effect of confounding factors. After using propensity score matching with a multivariable Cox regression model, age (p < 0.001), sex (p < 0.001), hypertension (p = 0.003), diabetes mellitus (p = 0.001), and renal disease (p < 0.001) were significantly associated with bladder cancer recurrence. However, there were no significant differences in the recurrence rates of bladder cancers in patients who received general anesthesia and spinal anesthesia for TURBTs. This study revealed that there is no relationship between the anesthetic method and bladder cancer recurrence. Either general anesthesia or regional anesthesia can be used depending on the situation in patients receiving TURBT. Future prospective studies are warranted to confirm the association between the anesthetic method and the recurrence rates of bladder cancer.

The prevalence of catheter-associated urinary tract infections (CAUTIs) varies from 5% to 8.2%, and the risk of infection increases by 5% to 7% per day of primary indwelling. We investigated whether a novel biofilm inhibitory mechanism using an inhibitory silicone urethral catheter (a coated Foley catheter) can reduce CAUTIs compared to conventional non-coated Foley catheters.This study prospectively analyzed the difference in the incidence of CAUTIs in patients who underwent radical cystectomy with an orthotopic neobladder for bladder cancer and received a coated or conventional non-coated catheter. Additionally, differences in bacterial colonization between the groups were analyzed using a catheter-tip bacterial culture test.Eighty-five patients were randomized into the "coated Foley catheter" group (abbreviated as "case" group; 41 patients) and a control group (44 patients). The two groups were identical except for their surgical history. The incidence of CAUTIs 2 weeks after radical cystectomy was 21.95% (case) and 27.27% (control), with no significant difference between the two groups. However, when the catheter was removed 2 weeks after surgery, the catheter tip culture test revealed significant bacterial colonies in 25 (60.98%) and 38 (86.36%) patients in the case and control group, respectively. No catheter-related postoperative side effects were observed in either group.The incidence of CAUTIs in the two groups did not differ according to the catheter material. However, the catheter bacterial culture test showed that bacterial colonization was significantly suppressed on the Bi-Fi Free technology catheter, which comparatively inhibited biofilm formation.

Purpose To evaluate if preoperative sterile pyuria can be a prognostic factor for intravesical recurrence (IVR) and overall survival (OS)in patients with upper tract urothelial carcinoma (UTUC) undergoing surgery. Materials and methods We retrospectively reviewed the medical records of patients who were diagnosed with UTUC from October 2003 to December 2016 at Korea University Medical Center. Sterile pyuria was defined as urine containing five or more white blood cells per high-power field in the absence of bacteria in urine culture. We used a stepwise multivariable Cox proportional hazards model to assess the independent effects of the prognostic factors for IVR and OS. Results We investigated a total of 176 patients who were diagnosed with UTUC. Among them, 91 (51.7%) patients had preoperative sterile pyuria. There were no significant differences in the baseline characteristics between the pyuria and non-pyuria groups concerning tumor grade, T stage, tumor multiplicity, and recurrence history. However, there was a significant difference in the IVR between the two groups. In the multivariable analysis, preoperative sterile pyuria, diabetes mellitus, high-grade tumor, and lymphovascular invasion were revealed as independent risk factors for IVR, and only lymphovascular invasion was identified as an independent risk factor for OS. Conclusions Preoperative sterile pyuria is significantly associated with IVR in patients with UTUC undergoing surgery, but it is not associated with OS. Furthermore, diabetes mellitus, high-grade tumor, and lymphovascular invasion are also independent prognostic factors for these patients.

Purpose Previous studies have suggested that androgen deprivation therapy (ADT) is associated with cerebral infarction. However, conflicting results have been reported by other researchers. The aim of this study was to evaluate the association between ADT and cerebral infarction in patients with prostate cancer (PC) using big data. Materials and Methods Using information from the National Health Insurance Service database representative of the entire Korean adult PC population (n = 206 735), data regarding ADT and cerebral infarction between 2009 and 2016 were analyzed. Adjusted hazard ratios for cerebral infarction associated with ADT were estimated using propensity score‐matched Cox proportional hazards models and Kaplan‐Meier survival analyses. Results The final cohort comprised 36 146 individuals with PC, including 24 069 men (66.6%) who underwent ADT. During the mean follow‐up of 4.1 years, 2792 patients were newly diagnosed with cerebral infarction. In the unmatched cohort, there was a significant difference in the annual incidence of cerebral infarction between the ADT and non‐ADT groups (22.8 vs 14.6 per 1000 person‐years, respectively). However, there was no significant difference between the ADT and non‐ADT groups in the matched cohort (14.9 vs 14.6 per 1000 person‐years). The adjusted hazard ratio for cerebral infarction for PC patients who underwent ADT was 1.045 (95% CI 0.943‐1.159; P = 0.401) compared with those who did not undergo ADT. In addition, the cumulative duration of ADT was also not associated with an increased risk for cerebral infarction. However, older age, hypertension, diabetes, myocardial infarction, congestive heart failure, peripheral vascular disease, renal disease, dementia, and atrial fibrillation were revealed to be factors contributing to cerebral infarction. Conclusion This nationwide population‐based study revealed that ADT was not associated with cerebral infarction after adjusting for potential confounders.

Purpose To describe our initial experience with a novel method of adenoma retrieval using a pneumovesicum (PNV) after Holmium laser enucleation of the prostate (HoLEP). Methods From January 2016 to April 2018, a total of 93 consecutive patients treated with HoLEP were enrolled in this study. For tissue morcellation, we used the PNV morcellation technique for an initial series of 21 patients and the conventional technique (Lumenis VersaCut) for a consecutive series of 72 patients. We compared efficiency and safety between the novel technique and the traditional technique. Subgroup analysis was performed to assess the effectiveness of the current technique in the large prostate (>70 mL). Results There were significant differences in mean age and prostate volume between the 2 groups. However, there were no significant differences in the baseline characteristics and preoperative parameters in the subgroup analysis of large prostates (>70 mL). The mean morcellation efficiency was higher (8.50±1.94 minutes vs. 1.76±0.45 minutes, P

Purpose To analyze the prescription pattern for benign prostatic hyperplasia (BPH) based on the clinician's urology specialty. Methods We analyzed the data of patients treated with BPH from the National Health Insurance Database-Cohort (NHIDB) from 2002 to 2013. The information including the accompanying drugs, characteristics and medication treatment status of patients with BPH in Korea were analyzed; this included the type and number of medications prescribed, the ratios of prescriptions to other medications, and the underlying diseases. Results The prescription rates of alpha-blockers by non-urological clinicians were 40.5% in 2002 and 36.9% in 2013. In addition, the rates of anticholinergic and 5-alpha-reductase inhibitors prescribed by non-urological clinicians were 25% and 30%. The rates of BPH medication prescription by non-urologic experts were highest from internal medicine specialists (58.4%), and dermatology (8.3%), and general surgery (7.2%). With regards to anticholinergics, propiverine was prescribed most frequently followed by tolterodine, solifenacin succinate, fesoterodine, oxybutynin, and trospium. The proportion of prescriptions by non-urologists to urologists was 11.7% for solifenacin and 12.2% for fesoterodine. The prescription frequency of dutasteride was much lower than finasteride (56147 versus 262930), and the proportion of prescriptions by non-urologists to urologists was much lower in dutasteride (15.7%) versus finasteride (39.3%). Conclusions BPH prescriptions by non-urologists in Korea require to be verified by proper scientific values and more attention should be given to improve the quality of BPH care. Data from this study will ultimately lead to the evidence-based medication that could lead to more advanced BPH management.

Treatment strategies for metastatic urothelial carcinoma (mUC) have evolved dramatically over the last decade. The emergence of immunotherapeutic agents, especially immune checkpoint inhibitors, has been the most significant development. Immunotherapy increased the overall survival rate of patients with mUC and provided a durable response. The success of immune checkpoint inhibitors further led to the development of novel agents that regulate the immune system within the tumor microenvironment. However, despite some success with immune checkpoint inhibitors, researchers are still developing new agents, including small molecule tyrosine kinase inhibitors, mammalian target of rapamycin (mTOR) inhibitors, and novel fusion proteins, tailored for targets other than immune checkpoint inhibitors. Novel treatment strategies are being developed rapidly with ongoing pre-clinical trials. Here, we outline promising new therapies that are expected to improve survival rates for patients with mUC.

Special considerations should be made when selecting medications for the treatment of lower urinary tract symptoms (LUTS) in older patients especially those over 65 years old. This review summarizes the relationship between current treatments for LUTS and cognitive impairment. Although the recently reported association between dementia and tamsulosin is debatable, the effects of α-blockers and pharmacokinetics are not reported in this context. Five-alpha reductase inhibitors appear to affect mood. However, the association between the development of dementia and cognitive impairment is unlikely. Anticholinergic agents, other than trospium, fesoterodine, and imdafenacin have a relatively high distribution in the central nervous system. In particular, oxybutynin is reported to cause cognitive impairment. Several animal studies on the blood-brain barrier permeability of oxybutynin support this. Therefore, care must be taken when they are used in older patients (65 years and older). Beta-3 agonists are an alternative to, or may be used in combination with, anticholinergic drugs for patients with an overactive bladder (OAB). Several phase 2 and 3 clinical studies report high tolerability and efficacy, making them relatively safe for OAB treatment. However, there is a possibility that cognitive function may be affected; thus, long-term study data are required. We have reviewed studies investigating the correlation of urologic medications with cognitive dysfunction and have provided an overview of drug selection, as well as other considerations in older patients (65 years and older) with LUTS. This narrative review has focused primarily on articles indexed in PubMed, Google Scholar, Scopus, and Embase databases. No formal search strategy was used, and no meta-analysis of data was performed.

Objectives To evaluate the effects of 50 mg mirabegron once daily for ureteric stent-related discomfort after ureteroscopic procedures by conducting a multicentre randomized study. Patients and methods A total of 100 patients with indwelling ureteric stents after ureteroscopic stone removal or retrograde intrarenal surgery (RIRS) were randomized 1:1 to receive either no treatment or mirabegron during the stenting period. At the time of stent removal, the validated Ureteral Stent Symptom Questionnaire (USSQ), International Prostate Symptom Score (IPSS), total amount of analgesics administered, and post-voiding residual urine volume were reported for each patient. Results Overall, 96 patients were enrolled for analysis. The postoperative USSQ body pain score (21.96 vs 13.96; P = 0.007) and overall pain score (5.58 vs 2.83; P = 0.002) were lower in the mirabegron group than in the control group. The USSQ urinary symptom scores (32.58 vs 27.92; P = 0.582) and USSQ general health score (17.71 vs 14.00; P = 0.281) were also lower in the mirabegron group, but the difference was not significant. Postoperative IPSS total scores and quality-of-life scores were lower in the mirabegron group, but the difference was not significant. The change in IPSS storage symptom score, however, was lower in the mirabegron group than in the control group (3.58 ± 3.58 vs 1.83 ± 4.39; P = 0.035). Post-void residual urine volume did not differ between the two groups (P > 0.05). Conclusion The use of 50 mg mirabegron once daily has the potential to reduce ureteric stent-related discomfort. Prospective larger-scale, placebo-controlled studies are warranted to further evaluate the beneficial effects of mirabegron on stent-related symptoms.

Purpose The purpose of this study was to evaluate the association of androgen deprivation therapy (ADT) with cognitive dysfunction. Materials and methods Using the National Health Insurance Service database of the entire Korean adult prostate cancer population (n=236,391), data on ADT and cognitive dysfunction between 2008 and 2015 were analyzed. We excluded patients previously diagnosed with cognitive dysfunction, dementia, or a cerebral event history. We tested the effect of ADT on the risk of cognitive dysfunction using propensity score-matched Cox proportional hazards regression models and Kaplan-Meier survival analysis. Our final cohort comprised of 35,401 individuals with prostate cancer, including 24,567 men (70.6%) who underwent ADT. Results During a mean follow-up period of 4.1 years, 4,741 patients were newly diagnosed with cognitive dysfunction. A statistically significant association was found between ADT and the risk of cognitive dysfunction (hazard ratio, 1.169; p=0.002). Meanwhile, age (≥ 70 years), diabetes, hypertension, cardiovascular history, and peripheral vascular disease were identified as factors that contribute to the increased risk of cognitive dysfunction. In contrast, the use of statins and aspirin was associated with a lower risk of cognitive dysfunction. Kaplan-Meier analysis demonstrated that patients aged 70 years or older who underwent ADT had the lowest cumulative probability of remaining cognitive dysfunction-free (log-rank p Conclusion Our. Results revealed an association between the use of ADT for the treatment of prostate cancer and an increased risk of cognitive dysfunction in a nationwide population-based study. This finding should be further evaluated in prospective studies.

The purpose of this study was to identify the prognostic impact of intravesical recurrence (IVR) on oncologic outcomes and the clinicopathologic factors that predict IVR in patients who undergo radical nephroureterectomy (RNU) for upper tract urothelial carcinoma.Between January 2000 and December 2015, 760 patients with upper tract urothelial carcinoma underwent RNU at 5 institutions in Korea, and patient data were retrospectively collected. Clinicopathologic factors were analyzed for intravesical recurrence-free survival, cancer-specific survival (CSS), and overall survival (OS). Univariate and multivariate Cox proportional hazards regression models were used to test the clinicopathologic factors on IVR.Of the 760 patients, 231 (30.3%) patients experienced IVR within 10 months of the median interval between RNU and the first IVR. The overall estimated probabilities of 5-year CSS, intravesical recurrence-free survival, and OS were 84.2%, 63.8%, and 79.2%, respectively. No difference was noted in terms of CSS and OS between the patients who did or did not experience IVR. The multivariate Cox analysis showed an association between IVR and positive hydronephrosis, tumor size, positive preoperative urinary cytology, and ureterorenoscopy before RNU (all P .05). However, a significantly decreased risk of IVR was associated with female gender, laparoscopic RNU, and receipt of adjuvant systemic chemotherapy (all P .05).The occurrence of IVR following RNU did not affect CSS and OS. Patients with larger tumor size, preoperative hydronephrosis, positive preoperative urinary cytology, and ureterorenoscopy before RNU had a higher risk of IVR following RNU.

The aim of this study was to evaluate whether balneotherapy might be effective in patients with chronic pelvic pain (CPP) in the short term. This was an open and prospective pilot study. The balneotherapy programme was performed in a spa resort located in Wando Island, Republic of Korea from August 26 2018 to September 1 2018. It consisted of 10 heated seawater baths (38 °C, 20 minutes) and 10 mud-pack applications (40 °C, 10 minutes) for five days. Sixteen patients were enrolled. Upon analysing responses from a patient questionnaire, we found improvement in parameters such as pain, bladder irrigation symptoms and quality of life after balneotherapy. Inflammatory marker IL-1 and TNF-α was significantly decreased after treatment compared to baseline. There were no adverse events during treatment. Our data suggest that five-day balneotherapy can be beneficial for patients with CPP in the short term.Impact statement

A recent study demonstrated that tamsulosin increased the risk of dementia in patients with benign prostatic hyperplasia. However, this study had a number of limitations. We evaluated the association between α-blockers and dementia in patients with benign prostatic hyperplasia.From the National Health Insurance Service database we collected and analyzed data on α-blockers and dementia in the entire Korean adult population with benign prostatic hyperplasia between January 2011 and December 2011. These patients were followed until September 2017. We tested the effect of α-blockers on the risk of dementia using propensity score matched Cox proportional hazard regression models and Kaplan-Meier survival analysis.During a mean ± SD followup of 1,580 ± 674.3 days all study inclusion and exclusion criteria were met by 59,263 patients with benign prostatic hyperplasia. In the unadjusted cohort the incidence of dementia in the tamsulosin, doxazosin, terazosin, alfuzosin and no medication cohorts were 17.97%, 18.55%, 20.64%, 17.62% and 22.60%, respectively. After propensity score matching the risk of dementia did not significantly differ in the tamsulosin cohort vs the doxazosin and alfuzosin cohorts (HR 1.038, 95% CI 0.960-1.121 and HR 1.008, 95% CI 0.925-1.098), respectively. Compared to the tamsulosin cohort the terazosin cohort had a higher risk of dementia (HR 1.112, 95% CI 1.052-1.196). However, the risk of dementia was significantly lower in the terazosin cohort than in the no medication cohort.The study findings indicate that benign prostatic hyperplasia medication is not associated with a risk of dementia by duration of use or by type.

Urothelial bladder cancer (UBC) is the second most common type of malignancy in the urinary tract with high frequency of recurrence and high progression rate (1). European Urology Association (EAU) guidelines recommend radical cystectomy (RC) for muscle invasive bladder cancer or non-muscle invasive bladder cancer at highest risk of progression (2). Adjuvant chemotherapy after RC can be considered for high-risk M0 patients, such as pT3/4 and/or lymph node–positive disease (3). However, more than half of patients revealed hydronephrosis (HN) at time of RC and often require adjuvant chemotherapy. Cisplatin-based CTx, especially in patients with renal insufficiency, is a critical issue related to patient survival. For save renal function and treat HN, we may consider internal ureteral stenting (IUS) or percutaneous nephrostomy (PCN) tube insertion. Both procedures are well-established techniques for rapidly relieving ureteral obstruction and improving renal function. However, optimal management of malignant ureteral obstruction remains unclear before RC.

The gold standard for management of UTUC is radical nephroureterectomy (RNU). However, a large number of patients with UTUC have poor comorbidity and may experience serious complications after RNU. Thus, nephron-sparing treatment has been recently attempted in cases of low risk UTUC, especially in patients with low renal function and poor comorbidity.

Preoperative tumor staging and diagnosis are difficult with currently available imaging modalities, but clinical variables have been identified to enable risk stratification and distinguish high-risk and low-risk tumors (Baard et al., Nat Rev Urol 14:181–191, 2017). The EAU and Societe International d’Urologie (SIU)–International Consultation on Urological Diseases (ICUD) recommendations for imaging in UTUC diagnosis include urography using CT (CTU) or urography using MRI (Baard et al., Nat Rev Urol 14:181–191, 2017). In the standard diagnostic work-up, urine cytology and a cystoscopy are usually recommended to rule out a concomitant bladder tumor. In addition, diagnostic ureterorenoscopy and biopsy are recommended in patients in whom the findings of these procedures could influence treatment decisions, between radical nephroureterectomy and kidney-sparing treatment.

Upper urinary tract urothelial carcinoma (UTUC) can be defined as any neoplastic growth that affects the lining of the urinary tract from the renal calyces to the distal ureter. UTUC has similar behaviors to urothelial cell carcinoma in bladder (UBC), but prognosis and tumor characteristics are different. However, UTUC is known as a relatively rare disease and has poor prognosis than UBC.

Purpose To evaluate seasonal variations of overactive bladder (OAB) symptoms in women who visited hospital clinics. Methods Medical records of female patients treated for OAB symptoms from January 2011 to December 2017 were retrospectively reviewed. Patients with pyuria at the first visit, those who did not complete the questionnaire, and those with

We evaluated the prognostic value of BMP-2 expression in prostate cancer tissue via immunohistochemistry in prostate cancer patients. From July 2007 to August 2010, radical prostatectomy specimens from 90 patients with clinically localized prostate cancer (mean age, 62.7 years, mean follow-up 90.4 months) were assessed for BMP-2 expression using immunohistochemistry. We used stepwise multivariate Cox regression models stratified by study to assess the independent effects of the predictive factors and estimated hazard ratios (HRs). There were significant differences in the baseline characteristics of Gleason score (GS) and biochemical recurrence (BCR) between the groups with decreased and normal BMP-2 expression. Univariate analysis revealed GS, T stage (≥T3), and decreased BMP-2 expression as significant predictive determinants of BCR. In addition, GS (7: HR 2.836, p = 0.022; ≥8: HR 3.506, p = 0.048) and decreased BMP-2 expression (HR 2.007, p = 0.047) were significantly correlated with BCR in multivariate analysis. Overall five-year BCR-free survival rates in the group with decreased BMP-2 expression were worse than those in the group with normal expression. Therefore, decreased BMP-2 expression in prostate cancer tissue was correlated with the prognostic factors for BCR-free survival in patients with prostate cancer.

Background The purpose of this study was estimation of the cumulative incidence and lifetime prevalence of urolithiasis in Korea. Methods We used a National Health Insurance Service (NHIS) sample cohort dataset that included approximately 1 million individuals from Korea. Data from January 2002 to December 2013 were collected. We calculated the annual prevalence, recurrence rate, and estimate lifetime prevalence of urolithiasis. Multivariate logistic regression analysis was used to identify risk factors associated with urolithiasis. Results There were 57,921 diagnosed urolithiasis cases in the NHIS database over the 11 years studied. The annual incidence of urolithiasis increased every year (Poisson regression; hazard ratio, 1.025; P < 0.001). Of the patients with urolithiasis, 21.3% experienced disease recurrence within 5 years. The 11-year cumulative incidence was 5.71%, and the incidence in men was higher than that seen in women (7.07% vs. 4.34%, respectively). The 11-year cumulative incidence in the 60- to 69-year-old group (9.08%) was higher than that seen in any other age group. The overall standardized lifetime prevalence rate was estimated to be 11.5%: 12.9% in men and 9.8% in women. Meanwhile, age (> 60 years), income level, diabetes, body mass index, hypertension, and cancer history were identified as contributing factors to urolithiasis. Conclusion This study demonstrates that the annual incidence of urolithiasis in Korea is increasing. The overall standardized lifetime prevalence rate was higher than that reported in a previous report. This study is significant in that it is the first retrospective cohort study to estimate the lifetime prevalence of urolithiasis using a large national retrospective cohort., Graphical Abstract

Minimally invasive laparoscopic surgical procedures are increasingly being used in the management of various urological diseases. In particular, the laparoscopic approach for intravesical surgery using pneumovesicum (LPV) is a minimally invasive alternative with potential advantages including decreased morbidity, shorter hospital stays, and improved cosmesis. We review the applications of LPV in urology, summarize data for different surgical approaches, and provide an overview of patient management, as well as other considerations. This narrative review focused primarily on articles indexed in PubMed, Google Scholar, Scopus, and Embase databases. No formal search strategy was used, and no meta-analysis of data was performed.

The prognostic value of repeat transurethral resection of bladder tumor (TURBT) in patients with diagnosed high-risk, non-muscle-invasive bladder cancer (NMIBC) was investigated. We retrospectively reviewed the medical records of patients treated from October 2004 to December 2013 at Seoul National University who underwent repeated TURBT within 2-6 weeks after an initial resection. The study enrolled patients who had been diagnosed with NMIBC at both the initial and repeat TURBT; patients with muscle-invasive tumors on repeat TURBT were excluded. We used stepwise multivariate Cox regression models stratified by study to assess the independent effects of the predictive factors and estimated hazard ratios (HRs) from the Cox models. We investigated a total of 198 patients who were diagnosed with high-risk NMIBC. In logistic regression analyses, number of bladder tumors (2-7: OR, 2.319; 8≤: OR, 3.353; p